Informed consent and capacity in perioperative care: Legal analysis of two clinical cases

This article examines the medico-legal and ethical principles governing consent within perioperative practice through analysis of two contrasting clinical case studies. The first case involves a patient with decision-making capacity facing complex surgical decisions in the context of newly diagnosed metastatic malignancy. The second concerns a patient lacking capacity who required emergency surgical intervention, with treatment decisions governed by the Mental Capacity Act 2005. The discussion situates both cases within contemporary UK consent law, tracing the evolution from the Bolam professional standard through to the patient-centred disclosure framework established in Montgomery v Lanarkshire Health Board and subsequently qualified by McCulloch v Forth Valley Health Board. The application of best interests decision making, proxy decision-making through lasting power of attorney, and the proportionate use of restraint are examined in relation to the second case. The article demonstrates that perioperative practitioners have an active and legally significant role in supporting the validity of consent at the point of care. It concludes that consent within perioperative practice must be understood as a continuous communicative and professional responsibility, integrating legal obligations, ethical reasoning and multidisciplinary collaboration, rather than a single administrative event.